{"text_format":"3","workbook":"xlsx","n_sheets":6,"sheets":["記載例（事業所一覧）","補助協議書","所要額調書","事業計画書","事業計画書２","別紙1-3「ＩＣＴ活用による業務改善計画書」 (2)"],"not_rendered":{"defined_names":5,"comments":6},"read":"whole","date_system":"1900"}

{"sheet":"記載例（事業所一覧）","index":0,"n_rows":28,"n_cols":12,"rows_kept":28,"merged":[[1,0,1,9],[2,0,2,9],[4,5,4,6],[4,7,4,9],[6,0,6,8],[7,0,7,1],[7,2,7,6],[7,7,7,8],[8,0,8,1],[8,2,8,6],[8,7,8,8],[9,0,9,1],[9,2,9,6],[9,7,9,8],[10,0,10,1],[10,2,10,6],[10,7,10,8],[11,0,11,1],[11,2,11,6],[11,7,11,8],[12,0,12,1],[12,2,12,6],[12,7,12,8],[13,0,13,1],[13,2,13,6],[13,7,13,8],[14,0,14,1],[14,2,14,6],[14,7,14,8],[15,0,15,1],[15,2,15,6],[15,7,15,8],[16,0,16,1],[16,2,16,6],[16,7,16,8],[17,0,17,1],[17,2,17,6],[17,7,17,8],[18,0,18,1],[18,2,18,6],[18,7,18,8],[19,0,19,8],[22,0,23,1],[22,2,22,8],[23,2,23,8],[24,0,24,1],[24,2,24,8],[25,0,25,1],[25,2,25,8],[26,0,26,1],[26,2,26,8],[27,0,27,1],[27,2,27,8]]}
[]
[]
["申請事業所一覧"]
[]
[{"$nulls":5},"法人名",null,"社会福祉法人○○福祉会"]
[]
["申請事業所名の全てを以下に記載願います。",{"$nulls":10},"地域密着型特別養護老人ホーム"]
["施設種別",null,"施設・事業所名",{"$nulls":4},"（※区担当者使用欄）\n補助額",null,"委託契約締結(予定）日",null,"介護老人保健施設"]
["地域密着型特別養護老人ホーム",null,"特別養護老人ホーム▲▲",{"$nulls":6},"2022-09-01",null,"介護医療院"]
["認知症高齢者グループホーム",null,"グループホーム■■",{"$nulls":6},"2022-09-01",null,"介護療養型医療施設"]
[{"$nulls":11},"軽費老人ホーム"]
[{"$nulls":11},"有料老人ホーム"]
[{"$nulls":11},"サービス付き高齢者向け住宅"]
[{"$nulls":11},"短期入所生活介護"]
[{"$nulls":11},"短期入所療養介護"]
[{"$nulls":11},"認知症高齢者グループホーム"]
[{"$nulls":11},"小規模多機能型居宅介護事業所"]
[{"$nulls":11},"看護小規模多機能型居宅介護事業所"]
[{"$nulls":11},"生活支援ハウス"]
["※欄が不足する場合は、適宜追加してください。"]
[]
["当該補助金に係る関係書類の送付先、担当者の連絡先を記載してください。"]
["住　　所",null,"〒132-0000"]
[null,null,"東京都江戸川区中央〇丁目○番○号"]
["所　　属",null,"本部事務局"]
["担当者氏名",null,"事務局長　山田　太郎"]
["TEL",null,"０３－５６６２－００００"]
["E-mail",null,"    taro-yamada@hukushikai.co.jp"]

{"sheet":"補助協議書","index":1,"n_rows":30,"n_cols":52,"rows_kept":30,"merged":[[2,36,2,52],[3,36,3,52],[14,0,14,54],[19,0,19,54],[22,3,22,4],[22,5,22,17]]}
[]
[]
[]
[{"$nulls":36},"令和４年 ８月 １日"]
[]
[null,"江戸川区長　殿"]
[]
[]
[{"$nulls":25},"申請者"]
[{"$nulls":26},"所在地",{"$nulls":6},"東京都江戸川区中央〇丁目○番○号"]
[{"$nulls":26},"名称",{"$nulls":6},"社会福祉法人○○福祉会"]
[{"$nulls":26},"代表者職氏名",{"$nulls":10},"理事長　○○○○○",{"$nulls":13},"印"]
[]
[]
["令和４年度江戸川区地域密着型施設等の簡易陰圧装置の設置支援事業補助協議書"]
[]
[]
[null,"このことについて、下記のとおり提出します。"]
[]
["記　　　"]
[]
["１　交付申請額"]
[{"$nulls":3},"金",null,{"$f":"所要額調書!K47","v":{"v":46208000,"d":"46,208,000"}},{"$nulls":12},"円"]
[]
["２　添付書類"]
[null,"（１）所要額調書"]
[null,"（２）事業計画書"]
[null,"（３）平面図等"]
[null,"（４）見積書、契約書等"]
[null,"（５）その他参考となる資料"]

{"sheet":"所要額調書","index":2,"n_rows":62,"n_cols":16,"rows_kept":62,"merged":[[1,0,1,11],[3,1,3,4],[6,0,7,0],[6,1,7,1],[6,2,7,2],[6,3,7,3],[6,4,7,4],[6,5,7,5],[6,6,7,6],[6,7,7,7],[6,8,7,8],[6,9,7,9],[6,10,7,10],[6,11,7,11],[15,0,16,0],[15,1,16,1],[15,2,16,2],[15,3,16,3],[15,4,16,4],[15,5,16,5],[15,6,16,6],[15,7,16,7],[15,8,16,8],[15,9,16,9],[15,10,16,10],[15,11,16,11],[23,0,24,0],[23,1,24,1],[23,2,24,2],[23,3,24,3],[23,4,24,4],[23,5,24,5],[23,6,24,6],[23,7,24,7],[23,8,24,8],[23,9,24,9],[23,10,24,10],[23,11,24,11],[31,0,32,0],[31,1,32,1],[31,2,32,2],[31,3,32,3],[31,4,32,4],[31,5,32,5],[31,6,32,6],[31,7,32,7],[31,8,32,8],[31,9,32,9],[31,10,32,10],[31,11,32,11],[39,0,40,0],[39,1,40,1],[39,2,40,2],[39,3,40,3],[39,4,40,4],[39,5,40,5],[39,6,40,6],[39,7,40,7],[39,8,40,8],[39,9,40,9],[39,10,40,10],[39,11,40,11],[46,6,46,9],[46,10,46,11]]}
[]
["所要額調書"]
[]
["法 人 名","社会福祉法人　○○福祉会"]
[]
["（１）簡易陰圧装置の設置に係る経費支援事業",{"$nulls":10},"（単位：円）"]
["施設名","施設種別","総事業費\nA","補助対象経費\n実支出予定額\nB","寄附金その他\nの収入額\nC","差引後\n実支出予定額\nD＝B-C","補助単価\nE","設置予定台数(補助対象)\nF","補助基準額\nG＝E×F","補助基本額\nH\n(DとGを比較して少ない方の額)","補助率\nI","申請額\nJ=H×I"]
[]
["特別養護老人ホーム▲▲","地域密着型\n特別養護老人ホーム",{"v":4730000,"d":"4,730,000"},{"v":4648600,"d":"4,648,600"},null,{"$f":"D9-E9","v":{"v":4648600,"d":"4,648,600"}},{"v":4320000,"d":"4,320,000"},3,{"$f":"ROUNDDOWN(G9*H9,-3)","v":{"v":12960000,"d":"12,960,000"}},{"$f":"MIN(F9,I9)","v":{"v":4648600,"d":"4,648,600"}},"10分の10",{"$f":"ROUNDDOWN(J9*10/10, -3)","v":{"v":4648000,"d":"4,648,000"}}]
["グループホーム■■","認知症高齢者\nグループホーム",{"v":6600000,"d":"6,600,000"},{"v":6600000,"d":"6,600,000"},null,{"$f":"D10-E10","v":{"v":6600000,"d":"6,600,000"}},{"v":4320000,"d":"4,320,000"},5,{"$f":"ROUNDDOWN(G10*H10,-3)","v":{"v":21600000,"d":"21,600,000"}},{"$f":"MIN(F10,I10)","v":{"v":6600000,"d":"6,600,000"}},"10分の10",{"$f":"ROUNDDOWN(J10*10/10, -3)","v":{"v":6600000,"d":"6,600,000"}}]
[{"$nulls":5},{"$f":"D11-E11","v":0},{"v":4320000,"d":"4,320,000"},null,{"$f":"ROUNDDOWN(G11*H11,-3)","v":0},{"$f":"MIN(F11,I11)","v":0},"10分の10",{"$f":"ROUNDDOWN(J11*10/10, -3)","v":0}]
[{"$nulls":10},"計",{"$f":"SUM(L9:L11)","v":{"v":11248000,"d":"11,248,000"}}]
[]
["（２）感染拡大防止のためのゾーニング環境等の整備に係る経費支援事業"]
["　①　ユニット型施設の各ユニットへの玄関室設置によるゾーニング経費支援",{"$nulls":10},"（単位：円）"]
["施設名","施設種別","総事業費\nA","補助対象経費\n実支出予定額\nB","寄附金その他\nの収入額\nC","差引後\n実支出予定額\nD＝B-C","補助単価\nE","整備か所数\nF","補助基準額\nG＝E×F","補助基本額\nH\n(DとGを比較して少ない方の額)","補助率\nI","申請額\nJ=H×I"]
[]
["グループホーム■■","認知症高齢者\nグループホーム",{"v":9020000,"d":"9,020,000"},{"v":9020000,"d":"9,020,000"},null,{"$f":"D18-E18","v":{"v":9020000,"d":"9,020,000"}},{"v":1000000,"d":"1,000,000"},10,{"$f":"ROUNDDOWN(G18*H18,-3)","v":{"v":10000000,"d":"10,000,000"}},{"$f":"MIN(F18,I18)","v":{"v":9020000,"d":"9,020,000"}},"10分の10",{"$f":"ROUNDDOWN(J18*10/10, -3)","v":{"v":9020000,"d":"9,020,000"}}]
[{"$nulls":5},{"$f":"D19-E19","v":0},{"v":1000000,"d":"1,000,000"},null,{"$f":"ROUNDDOWN(G19*H19,-3)","v":0},{"$f":"MIN(F19,I19)","v":0},"10分の10",{"$f":"ROUNDDOWN(J19*10/10, -3)","v":0}]
[{"$nulls":5},{"$f":"D20-E20","v":0},{"v":1000000,"d":"1,000,000"},null,{"$f":"ROUNDDOWN(G20*H20,-3)","v":0},{"$f":"MIN(F20,I20)","v":0},"10分の10",{"$f":"ROUNDDOWN(J20*10/10, -3)","v":0}]
[{"$nulls":10},"計",{"$f":"SUM(L18:L20)","v":{"v":9020000,"d":"9,020,000"}}]
[]
["　②　従来型個室・多床室のゾーニング経費支援",{"$nulls":10},"（単位：円）"]
["施設名","施設種別","総事業費\nA","補助対象経費\n実支出予定額\nB","寄附金その他\nの収入額\nC","差引後\n実支出予定額\nD＝B-C","補助単価\nE","整備か所数\nF","補助基準額\nG＝E×F","補助基本額\nH\n(DとGを比較して少ない方の額)","補助率\nI","申請額\nJ=H×I"]
[]
["特別養護老人ホーム▲▲","地域密着型\n特別養護老人ホーム",{"v":5610000,"d":"5,610,000"},{"v":5610000,"d":"5,610,000"},null,{"v":5610000,"d":"5,610,000"},{"v":6000000,"d":"6,000,000"},1,{"v":5610000,"d":"5,610,000"},{"v":5610000,"d":"5,610,000"},"10分の10",{"$f":"ROUNDDOWN(J26*10/10, -3)","v":{"v":5610000,"d":"5,610,000"}}]
[{"$nulls":5},{"$f":"D27-E27","v":0},{"v":6000000,"d":"6,000,000"},null,{"$f":"ROUNDDOWN(G27*H27,-3)","v":0},{"$f":"MIN(F27,I27)","v":0},"10分の10",{"$f":"ROUNDDOWN(J27*10/10, -3)","v":0}]
[{"$nulls":5},{"$f":"D28-E28","v":0},{"v":6000000,"d":"6,000,000"},null,{"$f":"ROUNDDOWN(G28*H28,-3)","v":0},{"$f":"MIN(F28,I28)","v":0},"10分の10",{"$f":"ROUNDDOWN(J28*10/10, -3)","v":0}]
[{"$nulls":10},"計",{"$f":"SUM(L26:L28)","v":{"v":5610000,"d":"5,610,000"}}]
[]
["　③　家族面会室の整備等経費支援",{"$nulls":10},"（単位：円）"]
["施設名","施設種別","総事業費\nA","補助対象経費\n実支出予定額\nB","寄附金その他\nの収入額\nC","差引後\n実支出予定額\nD＝B-C","補助単価\nE","対象施設・\n事業所数\nF","補助基準額\nG＝E×F","補助基本額\nH\n(DとGを比較して少ない方の額)","補助率\nI","申請額\nJ=H×I"]
[]
["特別養護老人ホーム▲▲","地域密着型\n特別養護老人ホーム",{"v":4510000,"d":"4,510,000"},{"v":4510000,"d":"4,510,000"},null,{"$f":"D34-E34","v":{"v":4510000,"d":"4,510,000"}},{"v":3500000,"d":"3,500,000"},1,{"$f":"IF(F34=0,0,ROUNDDOWN(G34*H34,-3))","v":{"v":3500000,"d":"3,500,000"}},{"$f":"MIN(F34,I34)","v":{"v":3500000,"d":"3,500,000"}},"10分の10",{"$f":"ROUNDDOWN(J34*10/10, -3)","v":{"v":3500000,"d":"3,500,000"}}]
[{"$nulls":5},{"$f":"D35-E35","v":0},{"v":3500000,"d":"3,500,000"},1,{"$f":"IF(F35=0,0,ROUNDDOWN(G35*H35,-3))","v":0},{"$f":"MIN(F35,I35)","v":0},"10分の10",{"$f":"ROUNDDOWN(J35*10/10, -3)","v":0}]
[{"$nulls":5},{"$f":"D36-E36","v":0},{"v":3500000,"d":"3,500,000"},1,{"$f":"IF(F36=0,0,ROUNDDOWN(G36*H36,-3))","v":0},{"$f":"MIN(F36,I36)","v":0},"10分の10",{"$f":"ROUNDDOWN(J36*10/10, -3)","v":0}]
[{"$nulls":10},"計",{"$f":"SUM(L34:L36)","v":{"v":3500000,"d":"3,500,000"}}]
[]
["（３）多床室の個室化に要する改修費支援事業",{"$nulls":10},"（単位：円）"]
["施設名","施設種別","総事業費\nA","補助対象経費実支出予定額\nB","寄附金その他\nの収入額\nC","差引後\n実支出予定額\nD＝B-C","補助単価\nE","整備床数\nF","補助基準額\nG＝E×F","補助基本額\nH\n(DとGを比較して少ない方の額)","補助率\nI","申請額\nJ=H×I"]
[]
["特別養護老人ホーム▲▲","地域密着型\n特別養護老人ホーム",{"v":16830000,"d":"16,830,000"},{"v":16830000,"d":"16,830,000"},null,{"$f":"D42-E42","v":{"v":16830000,"d":"16,830,000"}},{"v":978000,"d":"978,000"},20,{"$f":"ROUNDDOWN(G42*H42,-3)","v":{"v":19560000,"d":"19,560,000"}},{"$f":"MIN(F42,I42)","v":{"v":16830000,"d":"16,830,000"}},"10分の10",{"$f":"ROUNDDOWN(J42*10/10, -3)","v":{"v":16830000,"d":"16,830,000"}}]
[{"$nulls":5},{"$f":"D43-E43","v":0},{"v":978000,"d":"978,000"},null,{"$f":"ROUNDDOWN(G43*H43,-3)","v":0},{"$f":"MIN(F43,I43)","v":0},"10分の10",{"$f":"ROUNDDOWN(J43*10/10, -3)","v":0}]
[{"$nulls":5},{"$f":"D44-E44","v":0},{"v":978000,"d":"978,000"},null,{"$f":"ROUNDDOWN(G44*H44,-3)","v":0},{"$f":"MIN(F44,I44)","v":0},"10分の10",{"$f":"ROUNDDOWN(J44*10/10, -3)","v":0}]
[{"$nulls":10},"計",{"$f":"SUM(L42:L44)","v":{"v":16830000,"d":"16,830,000"}}]
[]
[{"$nulls":6},"補助金交付申請額の合計金額 （円）",{"$nulls":3},{"$f":"SUM(L12,L21,L29,L37,L45)","v":{"v":46208000,"d":"46,208,000"}}]
[]
["(注） １　欄が足りない場合は、適宜行を追加して記入すること。"]
["　　　２　A欄、B欄は、別紙1-2「事業計画書」の事業費と一致させること。"]
["      ３　F欄は、別紙1-2「事業計画書」の「うち補助対象設置台数」、「整備か所数」又は「整備床数」と一致させること。"]
["　　　４　G欄及びJ欄には、千円未満の端数を切り捨てた額を記入すること。"]
{"$rows_empty":7}
[{"$nulls":15},"抵当権設定の有無"]
[{"$nulls":15},"有り"]
[{"$nulls":15},"無し"]

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[]
[]
["事業計画書"]
[]
["１　施設等の概要"]
["法人名","社会福祉法人 ○○福祉会",{"$nulls":7},"施設種別","地域密着型特別養護老人ホーム"]
["施設名","特別養護老人ホーム▲▲",{"$nulls":7},"開設年月日","1991-04-01"]
["施設所在地","東京都江戸川区中央一丁目○番○号",{"$nulls":7},"定員数",29,"人","(うち併設ショート",null,10,"人）"]
["建物竣工年月日","1990-12-20",null,null,"建物構造",null,"鉄骨造\n地上４階建",null,null,"延べ床面積",{"v":1500,"d":"1500.00"},"㎡","抵当権の有無",null,"無"]
["　＊ 特別養護老人ホームは、併設される短期入所生活介護事業所分を含めて記入すること。"]
[]
["２　簡易陰圧装置の設置に係る経費支援事業　(実施する場合のみ記載）"]
["事業内容\n（※１）","新型コロナウイルス等の感染が疑われる者が発生した場合に、当該利用者を隔離することが想定される静養室に簡易陰圧装置を１台設置する。また、感染が疑われる者が複数発生した場合に備え、居室に設置可能な陰圧ブースを２台購入する（通常時は４階倉庫に保管）。"]
["契約締結(予定)日\n(※２）","2022-09-01",null,null,"完了予定日\n(※２）",null,"2022-11-30",null,null,"設置予定\n台数",3,"台","うち補助対象\n台数(※３）",null,3,"台"]
["事業費　\n（※４）","区分",{"$nulls":4},"単価（円）",null,"数量","支出予定額（円）",null,null,"うち補助対象経費（円）"]
[null,"陰圧装置（型番XXXX）",{"$nulls":4},{"v":2000000,"d":"2,000,000"},null,1,{"v":2000000,"d":"2,000,000"},null,null,{"v":2000000,"d":"2,000,000"}]
[null,"陰圧装置（型番YYYY）",{"$nulls":4},{"v":600000,"d":"600,000"},null,2,{"v":1200000,"d":"1,200,000"},null,null,{"v":1200000,"d":"1,200,000"}]
[null,"静養室ダクト工事委託費",{"$nulls":4},"一式",null,null,{"v":1000000,"d":"1,000,000"},null,null,{"v":1000000,"d":"1,000,000"}]
[null,"工事事務費（設計監督料）",{"$nulls":7},{"v":100000,"d":"100,000"},null,null,{"$f":"MIN(J19,M18*0.026)","v":{"v":26000,"d":"26,000"}}]
[null,"消費税",{"$nulls":7},{"$f":"SUM(J16:L19)*0.1","v":{"v":430000,"d":"430,000"}},null,null,{"$f":"SUM(M16:P19)*0.1","v":{"v":422600,"d":"422,600"}}]
[null,"合計額（総事業費）",{"$nulls":7},{"$f":"SUM(J16:L20)","v":{"v":4730000,"d":"4,730,000"}},null,null,{"$f":"SUM(M16:P20)","v":{"v":4648600,"d":"4,648,600"}}]
[]
["３　感染拡大防止のためのゾーニング環境等の整備に係る経費支援事業　(実施する場合のみ記載）"]
["　①　ユニット型施設の各ユニットへの玄関室設置によるゾーニング経費支援"]
["事業内容（※１）"]
["契約締結(予定)日\n(※２）",{"$nulls":3},"完了予定日\n(※２）",{"$nulls":4},"整備か所数",{"$nulls":4},"か所"]
["事業費　\n（※４）","区分",{"$nulls":4},"単価（円）",null,"数量","支出予定額（円）",null,null,"うち補助対象経費（円）"]
[]
[]
[]
[]
[]
[null,"合計額（総事業費）",{"$nulls":7},{"$f":"SUM(J28:L32)","v":0},null,null,{"$f":"SUM(M28:P32)","v":0}]
[]
["　②　従来型個室・多床室のゾーニング経費支援"]
["事業内容\n（※１）","感染者が発生した場合に感染者と非感染者の動線を分離するため、現在浴室が設置されていない３階東側エリアについて、倉庫を改修して浴室を設置する。"]
["契約締結(予定)日\n(※２）","2022-11-01",null,null,"完了予定日\n(※２）",null,"2023-03-31",null,null,"整備か所数",null,null,1,null,"か所"]
["事業費　\n（※４）","区分",{"$nulls":4},"単価（円）",null,"数量","支出予定額（円）",null,null,"うち補助対象経費（円）"]
[null,"工事委託費",{"$nulls":4},"一式",null,null,{"v":5000000,"d":"5,000,000"},null,null,{"v":5000000,"d":"5,000,000"}]
[null,"工事事務費（設計監督料）",{"$nulls":4},"一式",null,null,{"v":100000,"d":"100,000"},null,null,{"$f":"MIN(J40,M39*0.026)","v":{"v":100000,"d":"100,000"}}]
[null,"消費税",{"$nulls":7},{"$f":"SUM(J39:L40)*0.1","v":{"v":510000,"d":"510,000"}},null,null,{"$f":"SUM(M39:P40)*0.1","v":{"v":510000,"d":"510,000"}}]
[]
[]
[null,"合計額（総事業費）",{"$nulls":7},{"$f":"SUM(J39:L43)","v":{"v":5610000,"d":"5,610,000"}},null,null,{"$f":"SUM(M39:P43)","v":{"v":5610000,"d":"5,610,000"}}]
[]
["　③　家族面会室の整備等経費支援"]
["事業内容\n（※１）","１階の面会室２部屋について、施設外から直接出入り可能な出入口を１か所ずつ追加するほか、各面会室のテーブル上にアクリル板を設置する。"]
["契約締結(予定)日\n(※２）","2022-09-01",null,null,"完了予定日\n(※２）",null,"2022-11-30",null,null,"家族面会室の併設施設との共用の有無\n（※５）",{"$nulls":3},"無"]
["事業費　\n（※４）","区分",{"$nulls":4},"単価（円）",null,"数量","支出予定額（円）",null,null,"うち補助対象経費（円）"]
[null,"工事委託費",{"$nulls":4},"一式",null,null,{"v":4000000,"d":"4,000,000"},null,null,{"v":4000000,"d":"4,000,000"}]
[null,"工事事務費（設計監督料）",{"$nulls":4},"一式",null,null,{"v":100000,"d":"100,000"},null,null,{"$f":"MIN(J51,M50*0.026)","v":{"v":100000,"d":"100,000"}}]
[null,"消費税",{"$nulls":7},{"$f":"SUM(J50:L51)*0.1","v":{"v":410000,"d":"410,000"}},null,null,{"$f":"SUM(M50:P51)*0.1","v":{"v":410000,"d":"410,000"}}]
[]
[]
[null,"合計額（総事業費）",{"$nulls":7},{"$f":"SUM(J50:L54)","v":{"v":4510000,"d":"4,510,000"}},null,null,{"$f":"SUM(M50:P54)","v":{"v":4510000,"d":"4,510,000"}}]
[]
["４　多床室の個室化に要する改修費支援事業　(実施する場合のみ記載）"]
["事業内容（※１）","２階の４人室５室について、各利用者のスペースをパーテーションでで囲うとともに、個室化に伴って必要となるスプリンクラーの設置工事を行う。"]
["契約締結(予定)日\n(※２）","2022-11-01",null,null,"完了予定日\n(※２）",null,"2023-03-31",null,null,"整備床数",null,null,20,null,"床"]
["事業費　\n（※４）","区分",{"$nulls":4},"単価（円）",null,"数量","支出予定額（円）",null,null,"うち補助対象経費（円）"]
[null,"パーテーション設置工事委託費",{"$nulls":4},"一式",null,null,{"v":7000000,"d":"7,000,000"},null,null,{"v":7000000,"d":"7,000,000"}]
[null,"スプリンクラー設置工事委託費",{"$nulls":4},"一式",null,null,{"v":8000000,"d":"8,000,000"},null,null,{"v":8000000,"d":"8,000,000"}]
[null,"工事事務費（設計監督料）",{"$nulls":4},"一式",null,null,{"v":300000,"d":"300,000"},null,null,{"v":300000,"d":"300,000"}]
[null,"消費税",{"$nulls":7},{"$f":"SUM(J61:L63)*0.1","v":{"v":1530000,"d":"1,530,000"}},null,null,{"$f":"SUM(M61:P63)*0.1","v":{"v":1530000,"d":"1,530,000"}}]
[]
[null,"合計額（総事業費）",{"$nulls":7},{"$f":"SUM(J61:L65)","v":{"v":16830000,"d":"16,830,000"}},null,null,{"$f":"SUM(M61:P65)","v":{"v":16830000,"d":"16,830,000"}}]
[]
[" ※１ 設備の設置場所や工事内容等を具体的に記載し、設置場所・施工箇所等が確認できる資料(平面図等）を添付すること。"]
[" ※２ 補助の対象となる事業は、令和4年6月27日以降に契約し、令和5年3月31日までに完了するものに限る。"]
[" ※３ 補助対象となる簡易陰圧装置は、居室、静養室又は医務室に設置したものに限る。\n　　　また、簡易陰圧装置設置した居室等の数又は施設の定員のいずれか少ない方の数を上限とする。"]
[" ※４ 総事業費、補助対象経費等が確認できるもの（見積書・契約書等の写しなど）を添付すること。\n　　　工事事務費（工事施工のため直接必要な事務に要する費用であって、旅費、消耗品費、通信運搬費、印刷製本費及び設計\n 　　 監督料等をいう。）を計上する場合、補助対象経費は、工事費又は工事請負費（備品購入費に相当する経費は除く。）の\n　　　2.6％に相当する額を上限とする。"]
[" ※５ 整備対象の「家族面会室」を共用する併設施設の有無を記載すること。なお、併設施設と共用する家族面会室の場合は、\n　　　いずれか一つの施設・事業所で申請すること。"]

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[]
[]
["事業計画書"]
[]
["１　施設等の概要"]
["法人名","社会福祉法人 ○○福祉会",{"$nulls":7},"施設種別","認知症高齢者グループホーム"]
["施設名","グループホーム■■",{"$nulls":7},"開設年月日","2010-06-01"]
["施設所在地","東京都江戸川区中央一丁目○番○号",{"$nulls":7},"定員数",18,"人","(うち併設ショート",null,null,"人）"]
["建物竣工年月日","2010-03-31",null,null,"建物構造",null,"鉄骨造\n地上2階建",null,null,"延べ床面積",{"v":500,"d":"500.00"},"㎡","抵当権の有無",null,"無"]
["　＊ 特別養護老人ホームは、併設される短期入所生活介護事業所分を含めて記入すること。"]
[]
["２　簡易陰圧装置の設置に係る経費支援事業　(実施する場合のみ記載）"]
["事業内容\n（※１）","新型コロナウイルス等の感染が疑われる者が発生した場合に備え、居室に設置可能な陰圧ブースを５台購入する（通常時は１階倉庫に保管）。"]
["契約締結(予定)日\n(※２）","2022-10-10",null,null,"完了予定日\n(※２）",null,"2022-10-31",null,null,"設置予定\n台数",5,"台","うち補助対象\n台数(※３）",null,5,"台"]
["事業費　\n（※４）","区分",{"$nulls":4},"単価（円）",null,"数量","支出予定額（円）",null,null,"うち補助対象経費（円）"]
[null,"陰圧装置（型番ZZZZZ）",{"$nulls":4},{"v":1200000,"d":"1,200,000"},null,5,{"$f":"G16*I16","v":{"v":6000000,"d":"6,000,000"}},null,null,{"$f":"J16","v":{"v":6000000,"d":"6,000,000"}}]
[null,"消費税",{"$nulls":7},{"$f":"SUM(J16)*0.1","v":{"v":600000,"d":"600,000"}},null,null,{"v":600000,"d":"600,000"}]
[]
[]
[]
[null,"合計額（総事業費）",{"$nulls":7},{"$f":"SUM(J16:L20)","v":{"v":6600000,"d":"6,600,000"}},null,null,{"$f":"SUM(M16:P20)","v":{"v":6600000,"d":"6,600,000"}}]
[]
["３　感染拡大防止のためのゾーニング環境等の整備に係る経費支援事業　(実施する場合のみ記載）"]
["　①　ユニット型施設の各ユニットへの玄関室設置によるゾーニング経費支援"]
["事業内容（※１）","各ユニットの入口に玄関室を設置し、消毒や防護服の着脱等を行うためのスペースを確保する。\n"]
["契約締結(予定)日\n(※２）","2022-09-01",null,null,"完了予定日\n(※２）",null,"2022-11-30",null,null,"整備か所数",null,null,2,null,"か所"]
["事業費　\n（※４）","区分",{"$nulls":4},"単価（円）",null,"数量","支出予定額（円）",null,null,"うち補助対象経費（円）"]
[null,"工事委託費",{"$nulls":4},"一式",null,null,{"v":8000000,"d":"8,000,000"},null,null,{"v":8000000,"d":"8,000,000"}]
[null,"工事事務費（設計監督料）",{"$nulls":4},"一式",null,null,{"v":200000,"d":"200,000"},null,null,{"v":200000,"d":"200,000"}]
[null,"消費税",{"$nulls":7},{"$f":"SUM(J28:L29)*0.1","v":{"v":820000,"d":"820,000"}},null,null,{"$f":"SUM(M28:P29)*0.1","v":{"v":820000,"d":"820,000"}}]
[]
[]
[null,"合計額（総事業費）",{"$nulls":7},{"$f":"SUM(J28:L32)","v":{"v":9020000,"d":"9,020,000"}},null,null,{"$f":"SUM(M28:P32)","v":{"v":9020000,"d":"9,020,000"}}]
[]
["　②　従来型個室・多床室のゾーニング経費支援"]
["事業内容\n（※１）"]
["契約締結(予定)日\n(※２）",{"$nulls":3},"完了予定日\n(※２）",{"$nulls":4},"整備か所数",{"$nulls":4},"か所"]
["事業費　\n（※４）","区分",{"$nulls":4},"単価（円）",null,"数量","支出予定額（円）",null,null,"うち補助対象経費（円）"]
[]
[]
[]
[]
[]
[null,"合計額（総事業費）",{"$nulls":7},{"$f":"SUM(J39:L43)","v":0},null,null,{"$f":"SUM(M39:P43)","v":0}]
[]
["　③　家族面会室の整備等経費支援"]
["事業内容\n（※１）"]
["契約締結(予定)日\n(※２）",{"$nulls":3},"完了予定日\n(※２）",{"$nulls":4},"家族面会室の併設施設との共用の有無\n（※５）"]
["事業費　\n（※４）","区分",{"$nulls":4},"単価（円）",null,"数量","支出予定額（円）",null,null,"うち補助対象経費（円）"]
[]
[]
[]
[]
[]
[null,"合計額（総事業費）",{"$nulls":7},{"$f":"SUM(J50:L54)","v":0},null,null,{"$f":"SUM(M50:P54)","v":0}]
[]
["４　多床室の個室化に要する改修費支援事業　(実施する場合のみ記載）"]
["事業内容（※１）"]
["契約締結(予定)日\n(※２）",{"$nulls":3},"完了予定日\n(※２）",{"$nulls":4},"整備床数",{"$nulls":4},"床"]
["事業費　\n（※４）","区分",{"$nulls":4},"単価（円）",null,"数量","支出予定額（円）",null,null,"うち補助対象経費（円）"]
[]
[]
[]
[]
[]
[null,"合計額（総事業費）",{"$nulls":7},{"$f":"SUM(J61:L65)","v":0},null,null,{"$f":"SUM(M61:P65)","v":0}]
[]
[" ※１ 設備の設置場所や工事内容等を具体的に記載し、設置場所・施工箇所等が確認できる資料(平面図等）を添付すること。"]
[" ※２ 補助の対象となる事業は、令和4年6月27日以降に契約し、令和5年3月31日までに完了するものに限る。"]
[" ※３ 補助対象となる簡易陰圧装置は、居室、静養室又は医務室に設置したものに限る。\n　　　また、簡易陰圧装置設置した居室等の数又は施設の定員のいずれか少ない方の数を上限とする。"]
[" ※４ 総事業費、補助対象経費等が確認できるもの（見積書・契約書等の写しなど）を添付すること。\n　　　工事事務費（工事施工のため直接必要な事務に要する費用であって、旅費、消耗品費、通信運搬費、印刷製本費及び設計\n 　　 監督料等をいう。）を計上する場合、補助対象経費は、工事費又は工事請負費（備品購入費に相当する経費は除く。）の\n　　　2.6％に相当する額を上限とする。"]
[" ※５ 整備対象の「家族面会室」を共用する併設施設の有無を記載すること。なお、併設施設と共用する家族面会室の場合は、\n　　　いずれか一つの施設・事業所で申請すること。"]

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[{"$nulls":12},"別紙１-３"]
["ＩＣＴ活用による業務改善計画書"]
[]
[]
["１-１　法人・事業所概要"]
[]
["法人名"]
["事業所名称"]
["対象事業所種別"]
[]
[]
["事業所所在地","〒"]
[null,"東京都"]
[]
["１-２　現在の事業所の状況"]
[]
["定員数","ユニット型"]
[null,"従来型"]
["建物構造",{"$nulls":5},"延床面積"]
["対象事業所種別",{"$nulls":3},"（　　　　床）"]
[]
[{"$nulls":4},"（　　　　　　　　　　　　　　　　　　　　　　　　　　　）"]
["職員数","介護職員",null,"常勤",null,null,"非常勤",null,null,"計"]
[null,"看護職員",null,"常勤",null,null,"非常勤",null,null,"計"]
[null,"合計",null,"常勤",null,null,"非常勤",null,null,"計"]
[]
["※補助申請年度の４月１日時点の情報を記入してください。"]
["※職員数は、併設ショートステイを含めて記載し、その他併設サービスは含まずに記載ください。"]
[{"$nulls":13},"　※ＨＰ等での公表は２－１以降"]
["２-１　事業所の概要"]
["対象事業所種別"]
[]
[]
["法人名・施設名"]
["竣工年月日"]
["定員数"]
["建物構造",{"$nulls":5},"延床面積"]
["２-２　法人・事業所における解決課題"]
["　申請する事業所における現状の問題点、ＩＣＴ活用によって解決したいと考えている課題、効率化を図りたい介護業務等を具体的に記載してください。"]
["（現状の問題点、取り組むべき課題）"]
["（ＩＣＴ化する介護業務等）"]
["２-３　法人・事業所における検討状況、組織体制"]
["　この申請にあたり、ＩＣＴ環境整備及びＩＣＴ機器導入に当たり、法人・事業所内でのどのような検討を行ったか、ＩＣＴ導入を担当する組織体制など具体的に記載してください。"]
["（内部での検討状況）"]
["（ＩＣＴ導入のための組織体制）"]
["理事会等の\n議事録","ＩＣＴによる業務改善計画の内容、環境整備や機器等の購入に係る各理事等の発言内容や質疑応答など、法人内部での意思決定過程がわかる詳細な議事録を作成し、原本証明した写しを別途提出すること。",{"$nulls":11},"※議事録はＨＰ公表なし"]
[]
["２-４　業務改善計画（基本単価に関するもの）"]
["１　利用者処遇業務に関するＩＣＴ導入前の外部コンサルティング"]
["　外部コンサルティングの活用"]
["　活用する場合、委託先及び内容を具体的に記載してください。"]
["（委託先）"]
["（委託内容）"]
["２　利用者処遇業務に関するＩＣＴを活用した業務改善"]
["　ＩＣＴを活用した以下の（１）から（３）にまたがる業務改善計画と想定する効果を具体的に記載してください。"]
["（１）利用者又は利用者の居室に関すること","（業務改善計画：ＩＣＴを活用した課題の解決策）",{"$nulls":7},"（想定する効果・目標値）"]
["（２）介護職員等（直接利用者の処遇に当たる職員）に関すること","（業務改善計画：ＩＣＴを活用した課題の解決策）",{"$nulls":7},"（想定する効果・目標値）"]
["（３）スタッフステーションに関すること","（業務改善計画：ＩＣＴを活用した課題の解決策）",{"$nulls":7},"（想定する効果・目標値）"]
[]
["※見守り支援機器を導入する場合"]
["追加資料","身体拘束に抵触しないか確認するため、以下を別途提出すること。（身体拘束廃止未実施減算のおそれあり）\n・身体的拘束の適正化のための指針\n・見守り支援機器活用に対する考え方（指針に記されていない場合は別途提出）",{"$nulls":11},"※追加資料はＨＰ公表なし"]
[]
["３　ＩＣＴ環境整備計画"]
["既存のＩＣＴ環境有無","ＷｉＦｉ環境　",{"$nulls":3},"（",null,"　・",null,"）"]
["本事業におけるＩＣＴ環境整備計画","実施予定"]
[null,"　整備内容：",{"$nulls":11},"本体施設、加算単価の対象となる併設サービス、それ以外が区別できるよう平面図を色分けすること"]
[]
["４　ＩＣＴ機器導入計画"]
[null,"導入機器等",null,"メーカー",null,"仕様",null,"台数","選定理由",null,null,"備考"]
["導入に要するＩＣＴ機器\n（導入機器、ソフトウェア、メーカー、仕様、台数、選定理由等について記載してください。）",{"$nulls":12},"←記載例で「備考」欄に台数の根拠を入れておく"]
[]
[]
[]
[]
[]
[]
["２-５　業務改善計画（加算単価に関するもの）"]
["１　組織管理業務、併設サービスに関するＩＣＴを活用した業務改善"]
["　加算単価の申請"]
["　加算単価の申請がある場合、ＩＣＴを活用した組織管理業務、併設サービス等（※併設ショートステイに関する費用は基本単価に含む）における業務改善計画と想定する効果を具体的に記載してください。"]
["（業務改善計画：ＩＣＴを活用した課題の解決策）",{"$nulls":8},"（想定する効果・目標値）"]
["２　ＩＣＴ機器導入計画"]
[null,"導入機器等",null,"メーカー",null,"仕様",null,"台数","選定理由",null,null,"備考"]
["導入に要するＩＣＴ機器\n（導入機器、ソフトウェア、メーカー、仕様、台数、選定理由等について記載してください。）",{"$nulls":12},"←記載例で「備考」欄に台数の根拠を入れておく"]
[]
[]
[]
[]
[]
["※適宜、枠を拡大してください。別紙添付としても構いません。",{"$nulls":12},"←記載例にかいておく！"]